Antimicrobial photodynamic therapy suppresses dental plaque formation in healthy adults: a randomized controlled clinical trial

BMC Oral Health

Yuichi Izumi²  Isao Ishikawa⁶  Toshiyuki Itoh⁵  Yutaka Maruoka⁷  Fumihiko Yoshino³  Masaichi-Chang-il Lee⁴  Takuro Shimbo⁸  Teruo Kirikae¹  Yasuo Takeuchi²  Akira Aoki²  Akiko Ichinose-Tsuno² 

[1] Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan;Department of Periodontology, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8549, Japan;Department of Oral Science, Kanagawa Dental University Graduate School, Yokosuka, Kanagawa, Japan;Yokosuka-Shonan Disaster Health Emergency Research Center & ESR Laboratories, Kanagawa Dental University Graduate School, Yokosuka, Kanagawa, Japan;Department of Clinical Research, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan;Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan;Division of Oral Maxillofacial Surgery, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan;Ohta Nishinouchi Hospital, Koriyama, Fukushima, Japan

关键词: Randomized controlled trial;    Hydroxyl radical;    Dental plaque control;    Toluidine blue O;    Red light emitting diode;    Antimicrobial photodynamic therapy;   

Others  :  1090845
DOI  :  10.1186/1472-6831-14-152

 received in 2014-08-20, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

Oral care is important for oral and systemic health, especially for elderly institutionalized individuals and compromised patients. However, conventional mechanical plaque control is often difficult for these patients because of the pain or the risk of aspiration. Although antimicrobial photodynamic therapy (aPDT), which is considered an alternative or adjunct to mechanical approaches, has potential application as a less stressful method of daily plaque control, no clinical application of this technique has been reported.

Methods

We investigated the inhibitory effect of a combination of toluidine blue O (TBO), and a red light-emitting diode (LED) on dental plaque formation in healthy volunteers. The optimal concentration of TBO was determined in preliminary in vitro experiments to evaluate the bactericidal effect of aPDT on Streptococcus oralis and to clarify its safety in fibroblast cells. To survey the mechanism of TBO-mediated aPDT, the quality and quantity of reactive oxygen species (ROS) generated during aPDT were also examined using electron spin resonance (ESR) spectroscopy. Subsequently, the inhibitory effect of aPDT on dental plaque formation was investigated in eleven subjects as a clinical pilot study. The right or left mandibular premolars were randomly assigned to the treatment (with aPDT) or control (without aPDT) groups. In total, aPDT was applied six times (twice per day) to the teeth in the test group over a period of four days. On the fourth day, the study concluded and the analyses were performed.

Results

A combination of 500 or 1000 μg/ml TBO and LED irradiation for 20 s significantly decreased the number of colony forming units of Streptococcus oralis. The cytotoxicity of aPDT was comparable to that of standard antiseptics used in the oral cavity. Hydroxyl radicals were detected by ESR analysis, but singlet oxygen was not. A randomized controlled trial demonstrated that aPDT with 1000 μg/ml TBO and red LED irradiation significantly suppressed dental plaque formation without harming teeth or the surrounding tissues.

Conclusions

aPDT has the potential to be a promising novel technical modality for dental plaque control.

Trial registration

This trial was registered with University Hospital Medical Information Network Clinical Trials Registry (number UMIN000012504).

【 授权许可】

   
2014 Ichinose-Tsuno et al.; licensee BioMed Central.

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